A DIEP flap (deep inferior epigastric perforator) is a type of breast reconstruction in which blood vessels and the skin, and fat connected to them, are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy, without the sacrifice of any of the abdominal muscles.
How does it work?
An incision along the bikini line is made and the necessary skin, fat, and tiny blood vessels are removed. The fat and skin are shaped into a natural looking breast and sewn into place. The tiny blood vessels that feed the tissue of your new breast are matched to supplying vessels in your chest and reattached under a microscope. The procedure takes about 5-8 hours.
What are the benefits?
The main advantage of the DIEP flap is that only skin and fat from the abdomen are used to reconstruct the breast, leaving the abdominal muscles intact. This preserves the muscle strength in the abdominal region and helps prevent abdominal hernia caused by weakened muscles. A further advantage is that the blood supply to the skin and fat is improved when compared with a pedicled TRAM flap and the recovery is quicker and patients require only three to five days in hospital. In fact, the breast reconstruction surgery is often done alongside the mastectomy, removing the need for going through another round of surgery.
One decisive advantage of the DIEP flap method is that there is no synthetic material or implants used making it safer with fewer long-term side-effects.
Women who undergo this form of reconstruction also enjoy the added benefit of a flatter abdomen, with results that mimic a “tummy tuck” procedure.
How safe is the treatment?
Compared to women who have had TRAM flap surgery, women who have had DIEP have reportedly had less pain and more abdominal strength after surgery. But DIEP is still major surgery and you should expect to spend about 4 weeks recovering. As with all types of breast reconstruction however, 2 or 3 stages performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result.